Antibiotics for Both Moderate and Severe Cholera.

Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA.
New England Journal of Medicine (Impact Factor: 54.42). 01/2011; 364(1):5-7. DOI: 10.1056/NEJMp1013771
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    ABSTRACT: In this study, we have established an oral phage cocktail therapy in adult mice model and also performed a comparative analysis between phage cocktail, antibiotic and oral rehydration treatment for orally developed Vibrio cholerae infection. Four groups of mice were orally infected with Vibrio cholerae MAK 757 strain. Phage cocktail and antibiotic treated groups received 1 × 108 plaque forming unit/ml (once a daily) and 40 mg/kg (once a daily) as an oral dose respectively for consecutive three days after bacterial infection. In case of oral rehydration group, the solution was supplied after bacterial infection mixed with the drinking water. To evaluate the better and safer approach of treatment, tissue and serum samples were collected. Here, phage cocktail treated mice reduced the log10 numbers of colony per gram by 3 log10 (p < 0.05); however, ciprofloxacin treated mice reduced the viable numbers upto 5 log10 (p < 0.05). Whereas, the oral rehydration solution application was not able to reduce the viable bacterial count but the disease progress was much more diminished (p > 0.05).Besides, it was evident that antibiotic and phage cocktail treated group had a gradual decrease in both IL-6 and TNF-α level for 3 days (P < 0.05) but the scenario was totally opposite in bacterial control and oral hydration treated group. Histological examinations also endorsed the phage cocktail and ciprofloxacin treatment in mice. Although, in this murine model of cholera ciprofloxacin was found to be a better antimicrobial agent, but from the safety and specificity point of view, a better method of application could fill the bridge and advances the phages as a valuable agent in treating Vibrio cholerae infection.
    International journal of medical microbiology: IJMM 05/2014; DOI:10.1016/j.ijmm.2014.02.007 · 3.42 Impact Factor
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    ABSTRACT: Antibiotic resistance patterns amongst clinical V. cholerae O1 isolates Kuma et al. Abstract One of the protocols in the treatment and control of cholera infection is antibiotic therapy. However, increasing rates of antibiotic resistance amongst enteric bacteria including Vibrio cholerae have been reported in V. cholerae V. cholerae O1 to selected and commonly used antimicrobial agents and assessed resistance patterns across year periods. Additionally, the range of antibiotics currently effective for treatment and infection control during cholera outbreaks was ascertained. We screened a cumulative total of 277 isolates archived between 2010 and 2012 from the Greater Accra Region-Ghana, using the disc diffusion method. The recommendations of the Clinical and Laboratory Standards Institute were used to interpret our results. Resistance patterns were high for co-trimoxazole 232/241 (96.3%), trimethoprim 265/276 cholerae tetracycline are alternatives in the treatment and control of infection when not contra-indicated. Antibiotic resistance patterns amongst clinical V. cholerae O1 isolates Kuma et al. Introduction Cholera is an infection of the intestine with the bacterium Vibrio cholerae O1: El-Tor and Classical biotypes or O139, which produces an enterotoxin. The disease is characterised by acute illness with painless profuse watery diarrhoea with or without vomiting, leading to severe dehydration and death if treatment is not prompt.
    International Journal of Infection Control 01/2014; DOI:10.3396/IJIC.v10i3.023.14
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    ABSTRACT: Diarrhea is a major contributor to the burden of morbidity and mortality in children; it accounts for a median of 11% of all deaths among children aged less than 5 years, amounting to approximately 0.8 million deaths per year. Currently there is a dearth of literature exploring the effectiveness of antibiotics for diarrhea due to Cholera, Shigella and cryptosporidiosis in children. We reviewed the literature reporting the effect of antibiotics for the treatment of diarrhea due to Cholera, Shigella and Cryptosporidium in children under five years. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of the treatment with various antibiotics on mortality and rates of clinical and bacteriological/parasitological failure. The CHERG Standard Rules were applied to determine the final effect of treatment with antibiotics on diarrhea morbidity and mortality. For Cholera; the evidence was weak to recommend any effect on mortality. For Shigella; there was no data on mortality; either all-cause or cause specific, hence we used clinical failure rates as a proxy for Shigella deaths and propose that treatment of Shigella dysentery with antibiotics can result in a 82% reduction in diarrhea mortality due to Shigella. For cryptosporidiosis; there was data on all-cause mortality but the evidence was weak hence we used clinical failure rates as a proxy for mortality to estimate that antimicrobial treatment of diarrhea due to cryptosporidiosis can result in a 54% reduction in mortality. There is evidence to recommend antibiotic use for reduction of morbidity and mortality due to Cholera, Shigella and Cryptosporidium. We recommend that more clinical trials should be conducted to evaluate the efficacy and safety of first- and second- line drugs currently in use for treatment for diarrhea and dysentery in both developing and developed countries.
    BMC Public Health 09/2013; 13 Suppl 3(Suppl 3):S10. DOI:10.1186/1471-2458-13-S3-S10 · 2.32 Impact Factor


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